MetroHealth is Watching and Ready for Novel (New) Coronavirus
MetroHealth is paying close attention to the number of diagnosed cases of coronavirus in the United States and abroad. A map issued by Johns Hopkins sits open on the computer of Amy Ray, MD, medical director of infection prevention at MetroHealth. She carefully watches as more and more red circles fill the map, indicating confirmed cases of the virus.
Since Monday, the number of reported infections has jumped from 2,800 to 7,783 – five of these are in the U.S. As of Thursday, January 30, there have been 170 reported deaths.
While there are no suspected cases in Northeast Ohio, two students from Miami University in Oxford, Ohio, are being tested for the virus. They recently traveled to China and returned with flu symptoms. The students are being monitored in their homes by public health partners.
As a cautionary measure, MetroHealth updated its screening process for patients presenting with flu-like symptoms and recent travel to China. The travel screen has long been in place to aid in the detection of emerging infections such as Ebola and MERS-CoV.
It is an important tool to alert the clinical team early during a patient’s care. However, according to Dr. Ray, obtaining a travel history specific to Wuhan City or direct contact with a person with confirmed 2019-nCoV, along with an assessment for symptoms of infection, is key to early recognition of a person who may be at risk of novel coronaviral infection. Symptoms include fever with cough and shortness of breath.
Dr. Ray and her team are also working closely with local and state health agencies in the event a patient meets the criteria to be tested for novel coronavirus.
“A viral culture of infectious secretions is a biohazard risk and because this virus is so new, local public health agencies would help direct the transport of specimens to the Centers for Disease Prevention (CDC) for testing,” explains Dr. Ray.
If you’ve had the common cold, you’ve had a coronavirus (HCoV), which was first identified in the 1960s. The concern over this latest coronavirus is that it is new, there are no vaccines and according to the CDC the complete clinical picture is still not fully clear.
More than likely a patient coming to the Emergency Department with flu-like symptoms will in fact have the flu. Since October, 70 patients have been hospitalized at MetroHealth with the flu.
“MetroHealth has recently implemented a visitation restriction which encourages visitors with flu-like symptoms to refrain from visiting their loved ones while hospitalized,” explains Andrea Villers, RN, infection prevention coordinator. “Thankfully, our emergency department is performing travel screening and if a patient traveled to China within the last 14 days and has flu symptoms, that’s when the bells and whistles go off.”
MetroHealth has been down this road before.
The two-year Ebola outbreak of 2014-2016 in West Africa resulted in 28,000 infected and 11,000 deaths. When cases were diagnosed in the U.S., MetroHealth launched an aggressive program to educate and train staff on the safe care and handling of patients with this highly communicable disease. By January 2015, MetroHealth was designated as an Ebola Treatment Center – the only one in Ohio – by the Centers for Disease Control and Prevention.
“We now have 23 nurses specially trained in caring for patients with highly communicable diseases,” says Jennifer Conti, RN, manager of infection prevention. Jennifer was one of the original team members who helped create the processes and protocols for MetroHealth’s Ebola treatment center.
Bi-monthly training that includes simulation of various scenarios with infectious diseases is conducted for this specialized team to reinforce the safe processes that must be followed to prevent exposure to the care team. Emergency Department nurses and medics also receive annual training, since there is a high likelihood a patient with an emerging infectious disease will first present in the emergency department.
“We are always prepared to care for someone,” says Andrea Villers, RN, infection prevention coordinator. “For novel coronavirus, we have developed a Novel Coronavirus Flow Chart so that employees know what to do from the time a patient shows up at any of our locations, to activation of our Specialty Disease Care Unit.”
While the novel coronavirus is receiving a lot of attention, it’s important to keep it in perspective, says Dr. Ray. So far this season, influenza is responsible for 8,200 deaths and 140,000 hospitalizations in the U.S., according to the CDC.
The MetroHealth System, Cuyahoga County’s public health system, is honoring its commitment to create a healthier community by building a new hospital on its main campus in Cleveland. The building and the 25 acres of green space around it are catalyzing the revitalization of MetroHealth’s West Side neighborhood.
MetroHealth broke ground on its new hospital in 2019. The project is being financed with nearly $1 billion the system borrowed on its own credit after dramatically improving its finances. In the past five years, MetroHealth’s operating revenue has increased by 40% and its number of employees by 21%. Today, its staff of 8,000 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. In the past year, MetroHealth has served 300,000 patients at more than 1.4 million visits in its hospitals and health centers, 75% of whom are uninsured or covered by Medicare or Medicaid.
The health system is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.
As an academic medical center, MetroHealth is committed to teaching and research. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses a Cleveland Metropolitan School District high school of science and health.
For more information, visit metrohealth.org.